HomeMy Public PortalAbout9683 BLACKLEY ST_Building__ APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY ENGINEER MAP BOOK Q PAGE PARCEL
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
MAKE CHECKS PAYABLE TO: -
HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
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DISTRICT N GROUPTBUIYPE PRO ESS€D BY
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STATISTICAL LASSIFICATION SEWER MA
LOT NO. BLOCK `
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TRACT Z~�✓ - U ZONE MAP
i 1 3S NOWOON LOTS
SIZE OF LOT�j O / SPECIAL
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ADDRESS G,P3 .E 4A9C
/� TYPE OF EXISTING SETBACK HIGHWAY + YARD
CITY �' CrJ HIGHWAY WIDTH FROM C.L.
ARCHITECT OR TEL. + }
ENGINEERC/!d//✓E NO. p�
LDG,SETBACK FROM "
ADDRESS SIDE PROP.LINEOF (STREET) V
TEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL cz
CONTRACTOR NO. HIGHWAY WIDTH FROM G.L. CF
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CITY CLASS CORNER CUTOFF YES ❑ NO ❑ z
CONSTRUCTION LENDER
NAME AND BRANCH SEE (REVERSE SIDE FOR SPECIAL APPROVALS
SQ FT. i
FTSNO. OF NO. OF c�` d
SIZE STORIES 1 FAMILIES NEW ❑ 7
USE OF ADD . �
STRUCTURE ALTER ❑ I +
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f-- REPAIR❑ �7
IGNATURE F
APPLICAN DEMOL ❑
VAL TION $ Z✓L7 �QQ )DATE APPROVALS , INSPECTOR'S SIGNATURE
P.•, PMT. ZL J FOUNDATION: LOCATION
F E S �� FEES �—Cl FORMS, MATERIALS
FRAME: FIRE STOPS, I� /� Q
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS ! i`Sb 73
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, 1.
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
I CERTIFY THAT IN DOING THE WORK AUTHORIZED a t
HEREBY I W LL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. ✓' - / 'yy//j
LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO - ,y
WORKMEN'S MPENSATION INSURANCE. LATH, EXT, �I'1 ✓� ��`:G..(( +p,G7
SIGNATUR F HOUSE NUMBER COR-
PERMITTE - RECT AND POSTED g
ADDRESS FINAL ---*-
PLAN CHECK VALIDATION (7 M.O. CASH _ PERM T ALIDATION . M.O. CASH
7 9i'3� APR26 6. 2J�3 D I 4 5 .5 0 A � ✓, • (_/
tr_ 2 3 4 4113 JUL 2C 1 D 8 2 .5 0 a �,
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES � ' ®' 1
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WM. J. FOX, CHIEF ENGINEER ®1
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT NO. PLAN CK. NO. PERMIT NO.
BUILDING Q L�
ADDRESSZ_.S
LOCALITY - -.74 f RECEIVED BY DATE OF APPL. DATE IIrSSUE
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NEAREST, -.J,,A-4 L BUNGcSa /J/! /
CROSS ST,
ADDRESS Q
OWNER QS. /� 44--j �
MAIL (� LOCALITY / J c-,ADDRESS ® �A ,k1.A� �'- e% NEAREST
CROSS ST.
CITY NOTEL'.. 'r, ( FIRE I LANS� I TYPE GR
ZONE
ARCHITECT OR TEL. `--�
ENGINEER NO. BLDG.
SETBACK LINE I A
ADDRESS APPROVED G
TEL. BY DATE
CONTRACTOR N� USE1 APPROVED
ZONE 0 BY DATE
ADDRESS ° HOUSE NUMBERING
LEGAL
DESCRIPTION LOT NO.3OCK MAP NUMBER —`' / FIELD CHECK BY
cUS`s`"1
TRACT v� NO. ASSIGNED BY ATF
NO. OF BLDGS. CORRECTIONS
SIZE OF LOT S O 'x l V/�1 I NOW ON LOT pj
S,
USH OFNO. OF
BXISTING.BLDG, FAMILIES _
DESCRIPTION OF WORK
NEW I L/rALTERATION I I ADDITION el
REPAIR I I DEMOLITION
SQ. FT. NO. OF
SIZE Q d ROOMS ( STORIES / Z
a
EXT. WALL S. _ .r I ROOF ,j�1 r
COVERING �J�,,,@giC� COVERING (/1/
USE OF STRUCTURE
APPROVALS
INSPECTOR'S SIGNATURE DATE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION
PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS I—z
CORRECT.
I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS,
HERRON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS
LAWS REGULATING B LDING CONSTRUCT ON. FURNACE: LOCATION,
SIGNATURE OF
GAS VENT, DUCTS
PERMITTERLATH, INT.
ADDRESS
LATH, EXT.
AUTHORIZED AGT. '
'= �e PLASTER, INT.
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76A638A• 0883 10-50 .� 6 v v 0 P. C. $ / --
0 6 " FEE C../ PLASTER, EXT.
pG�
VALUATION I `�, ®� FEE S�� �Q FINAL ���'�
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